Identificação de grupos de risco e associação com lesões periapicais

Abstract

Periapical lesions are mostly inflammatory reactions resulting from pulp necrosis and consequent bacterial contamination of the root canal system that result in an inflammatory response and consequent bone destruction of the dental periapical. Although, initially, it appears to be a local alteration, this condition can affect and suffer interference in the individual's systemic health pattern. Thus, the present study aimed to quantify and associate the prevalence of periapical lesions, according to the variables: alcoholism, systemic alterations, temporomandibular joint dysfunction (TMD), parafunctional habits, age, immunosuppression, anatomical location, sex, smoking and use of illicit drugs. . This research was characterized as an observational case-control study. The analyzed data were obtained from the medical records of patients treated at the Endodontic Clinic of the Federal University of Alfenas (UNIFAL-MG) between 2013 and 2020. 1379 medical records were analyzed, whose data were divided into two groups: G1, composed of medical records of patients who, at the time of diagnosis, presented periapical lesion and G2, formed by those who did not present lesion. For data analysis, chi-square statistical tests were performed and for confirmation, the Fisher test and the G test. To measure the strength of association between the variables, the odds ratio (Odds Ratio) was applied. As a result, the mean age of patients was calculated at 40 years. 868 patients (62.98%) were female, while 511 (37.05%) were male. 292 (21.17%) of the medical records analyzed belonged to smokers. 238 patients (31.76%) consumed alcoholic beverages. 788 patients (57.14%) of the collected medical records had systemic alterations, and the most prevalent condition reported was arterial hypertension, present in 292 patients (21.17%). 104 (7.54%) were immunocompromised. Regarding the use of illicit drugs, 50 (3.62%) patients declared themselves to be dependent, seven of them (0.51%) being former users. 408 of the analyzed records (29.58%) belonged to patients diagnosed with TMD, while 660 (47.86%) had parafunctional habits. Finally, periapical inflammatory changes were observed in 787 (57.07%) of the analyzed teeth. The variables that were associated with the increase in the prevalence of inflammatory periapical diseases were: posterior tooth with 64% more chance; smoking with 33.85%; use of illicit drugs with 97.37% and among the systemic alterations listed, there was a significant association between: psychological/psychiatric alterations with 43.44%, heart disease with 42.46%, gastritis with 37.18%, arterial hypertension with 34, 87%, and the presence of tumors with 67.59%. When checking the interference between the associations of variables in the prevalence of periapical diseases, this relationship was observed between smoking and alcoholism with 79.20% and between smoking, alcoholism and systemic alterations with 91.72%. Therefore, among the conditions evaluated in this study, those that increase the probability of prevalence of periapical lesions were posterior teeth, smokers, users of illicit drugs and patients with systemic alterations: psychological alterations, heart disease, gastritis, arterial hypertension and the presence of tumors.